2018—2023 年国内曼陀罗中毒事件文献分析

Literature analysis of mandala poisoning incidents in China from 2018 to 2023

关键词: 曼陀罗  急性中毒  抗胆碱能综合征  毒物检测

Keywords: mandala (atura stramonium)  acute poisoning  anticholinergic syndrome  toxin detection

摘 要: 检索 2018 年 1 月 1 日至 2023 年 12 月 31 日中国知网期刊全文数据库、万方数据资源、维普中文科技期刊全文数据库、中国生物医学文献服务系统、中华医学期刊全文数据库急性曼陀罗中毒病例报道和回顾性病例相关资料,最终纳入文献 38 篇,涉及 275 例患者;所有患者无精神相关疾病史,多数患者无基础疾病;多数患者(69.82%)的中毒原因为误食。临床表现复杂多样,主要包括口干、瞳孔散大、头晕、躁动不安、恶心呕吐、面色潮红、心率快、谵妄等,严重者可出现昏迷、多器官功能衰竭甚至死亡;69.45%的患者在中毒后 3 h 内出现症状,最长达6h。主要采取对症治疗,47 例患者使用胆碱能拮抗剂,38 例患者肌内注射新斯的明,9 例予皮下注射毛果芸香碱,122 例患者于 7d 内出院,6 例死亡。对疑似曼陀罗中毒病例, 应详细询问病史,并应用毒素检测及物种鉴定方法协助诊断,避免误诊、漏诊。

Abstract: The full-text databases of China National Knowledge Infrastructure (CNKI),Wanfang Data,VIP Chinese Science and Technology Journal,China Biomedical Literature Service System,and Chinese Medical Journal from January 1,2018 to December 31,2023,including reports of acute mandala poisoning cases and retrospective case related information were retrieved by computer.Finally,38 articles were included, involving 275 patients,all patients had no history of mental illness,and most of them had no underlying diseases, majority of poisoned patients (69.82%) caused by ingestion.The clinical manifestations were complex and diverse, mainly including dry mouth, dilated pupils,dizziness,restlessness, nausea and vomiting,flushed complexion, rapid heart rate, delirium, etc.,and coma,multiple organ failure or even death could occur in severe cases;69.45% of the patients experienced symptoms within 3 hours after poisoning with a maximum of 6 hours. The main treatment was symptomatic treatment,with 47 patients received cholinergic antagonists,38 patients received intramuscular injection of neostigmine,and 9 patients received subcutaneous injection of pilocarpine,44.36% of the patients (122 cases) were discharged within 7 days,and 6 patients died. Facing suspected cases the detail medical history and toxin detection were especially important for avoiding misdiagnosis, missed diagnosis.